Is a vegetarian diet healthy?

Vegetarian diets can be just as variable as omnivore diets. When speaking with patients who want to follow a vegetarian diet, take time to discuss the foods to eat to help ensure nutritional adequacy. This discussion can start with a list of some of the common forms of vegetarianism.

A semivegetarian is someone who occasionally eats meat. A lacto-ovo vegetarian is someone who excludes meat from the diet but consumes eggs and dairy products; a lacto-vegetarian excludes both eggs and meat from the diet. A vegan is someone who abstains from eating all animal products, including gelatin and, sometimes, even honey.

Lacto-ovo is the most common type of vegetarian diet. This type of diet has the least amount of nutritional deficiencies because it includes eggs and dairy products. Patients who follow a strict vegan diet usually should also take supplements.
VEGETARIAN-FRIENDLY NUTRIENT SOURCES

The American Dietetic Association states that well-planned vegetarian diets are healthful and nutritionally adequate.1 Below are some of the major nutritional components of a healthy diet and some common ways vegetarians may get them.

Calcium Nondairy sources of calcium include calcium-fortified cereals, orange juice, and soy drinks. Bok choy, legumes, broccoli, kale, and collard greens also contain calcium. Calcium supplements may still be needed, however, especially for women.

Iron There are two different types of iron: heme iron from meat and nonheme iron from fortified cereals, soybeans, legumes, potato skin, prune juice, raisins, and blackstrap molasses, among other foods. Nonheme iron is less bioavailable than iron from meat, and vegetarians require 1.8 times more iron daily than do carnivores because of this difference.2 Vegetarians should consume foods rich in vitamin C to help with iron absorption.

Zinc Another mineral vegetarians may need more of in their diet is zinc, again because zinc from animal products is absorbed more easily than is zinc from plants. Vegetarians may need 50% more zinc to make up for the bioavailability differences.3 Good plant sources of zinc include fortified grains, legumes, nuts, and soy foods.

Vitamin B12 This important nutrient is found naturally only in animal products, so vegans will need supplements. Vitamin B12 can be found in fortified cereals, soymilk, yeast substitutes, and some sea vegetables. Vitamin B6 is found in fortified cereals, potato skin, legumes, and bananas.

Vitamin D Vegans may have low levels of vitamin D, as it is found naturally in dairy products; it can be found in fortified cereals and soymilk as well. Vegans may need to take vitamin D substitutes.

Riboflavin Good plant-based sources of riboflavin are almonds, asparagus, bananas, legumes, and sweet potatoes. Fortified cereals and soymilk also are sources of this nutrient.

Omega 3 fatty acids Also known as linolenic acid, omega-3 fatty acids are commonly found in fish and eggs. Vegetarians can get linolenic acid by including flaxseed oil, canola oil, walnuts, and soybeans in their diet.

Protein Cooked beans (legumes) are a very good and popular source of protein for vegetarians. One cup of cooked beans provides the same amount of protein as 2 ounces of meat. Legumes include all types of beans, lentils, and peas. Nuts are also high in protein, but they have much more fat than beans and so can be a significant source of calories.
VEGETARIAN AND VEGAN CHILDREN

Children who follow a vegetarian or vegan diet will grow and thrive the same as other children as long as their diet is a well-planned one. Parents should be counseled about the appropriate nutritional needs for the formative developmental years. Enlisting the help of a nutritionist may be beneficial. Younger children may feel full before they have eaten an adequate amount of calories. Children should eat frequent meals and snacks that contain high-energy, nutrient-dense foods.4
BOTTOM LINE

With the proper focus on nutrition, vegetarian and vegan diets are very healthy and beneficial. Many resources about vegetarian diets and menus are available at the local public library and online. JAAPA

For information that can be photocopied and handed to patients, please see the next section.

Katie Iverson is the department editor for When the Patient Asks and practices at the Emergency Trauma Center, University of Iowa Hospitals and Clinics, Iowa City. She has indicated no relationships to disclose relating to the content of this article.

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